Risk factors for kala-azar in Bangladesh
Risk factors for kala-azar in Bangladesh
复制标题
DOI：
10.3201/eid1105.040718
复制
发表时间：
2005-05-01
影响因子：
11.8
通讯作者：
Maguire, JH
中科院分区：
文献类型：
--
作者：
Bern, C;Hightower, AW;Maguire, JH
自1990年以来，南亚经历了黑热病（内脏利什曼病）的死灰复燃。为了确定黑热病的危险因素，我们在孟加拉国社区进行了为期3年的横断面调查。通过病史、主动病例检测和血清学筛查，2,356名居民中有155人在2000年至2003年发病。3-45岁的人风险最高，性别之间没有显著差异。在年龄调整的多变量模型中，确定了3个因素：（家庭内比值比[OR] 25.4，95%可信区间[CI] 15-44; OR 3.2，50 m内95%CI 1.7-6.1），夏季使用蚊帐（OR 0.7，95%CI 0.53-0.93），每1,000 m（2）牛（OR 0.8，95%CI 0.70-0.94）。在收入、教育或职业、土地所有权或其他资产、住房材料和条件、在卧室里养山羊或鸡等方面没有发现差异。我们的数据证实了强大的集群，并表明，驱虫蚊帐可以有效地防止黑热病。
Since 1990, South Asia has experienced a resurgence of kala-azar (visceral leishmaniasis). To determine risk factors for kala-azar, we performed cross-sectional surveys over a 3-year period in a Bangladeshi community. By history, active case detection, and serologic screening, 155 of 2,356 residents had kala-azar with onset from 2000 to 2003. Risk was highest for persons 3-45 years of age, and no significant difference by sex was seen. In age-adjusted multivariable models, 3 factors were identified: proximity to a previous kala-azar patient (odds ratio [OR] 25.4, 95% confidence interval [CI] 15-44 within household; OR 3.2 95% CI 1.7-6.1 within 50 m), bed net use in summer (OR 0.7, 95% CI 0.53-0.93), and cattle per 1,000 m(2) (OR 0.8, 95% CI 0.70-0.94]). No difference was seen by income, education, or occupation; land ownership or other assets; housing materials and condition; or keeping goats or chickens inside bedrooms. Our data confirm strong clustering and suggest that insecticide-treated nets could be effective in preventing kala-azar.